Fearsome foursome factors of longevity
Following the recent blog that related a PLoS paper to end of year excess, this week a PLoS Medicine study evaluating the combined impact of four healthy forms of behaviour was devoured by journalists keen to remind us to stick to New Year resolutions. This was certainly the approach of the New Scientist who let their readers know that no matter how “fat or unhealthy you already are” the conclusions of the study by Kay-Tee Khaw and colleagues are important. Conducted amongst 20,000 participants in the UK, the study found that those who are non-smokers, take exercise, have a moderate alcohol intake and eat five servings of fruit and vegetables a day live on average an additional fourteen years of life compared with people who adopt none of these behaviours.
The BBC were also quick to report on the paper – even reproducing one of the figures – and by midday on Tuesday it had jumped to the most viewed article and the one that was emailed most to friends. Interviewed on the BBC Television News Nick Wareham, one of the authors of the paper, stressed that even small changes in behaviour can have a significant impact on the health of populations. Elsewhere in the UK, the paper was picked up by the Guardian and the Telegraph.
“Isn’t it all quite obvious?” asked a comment responding to the Daily Mail article about the research. Whilst there is overwhelming evidence that individual aspects of lifestyle – such as smoking and diet – affect health and longevity, the study Kay-Tee Khaw and colleagues quantified the combined impact of four, an approach that is not usually taken. The research forms part of the European Prospective Investigation into Cancer and Nutrition (EPIC): conducted across ten European countries, it is the largest investigation into diet and health ever undertaken. Certainly scepticism amongst the general public is one of the many factors that makes the translation of research into public health policy complex – the subject of our editorial – and this was also evident on the other side of the Atlantic in response to coverage by the Washington Post and Chicago Tribune amongst others. “With all these good habits, there’s still a chance you’ll be killed while out on a hiking trail” was one of the cheerful comments replying to the San Francisco Chronicle’s article. Those hoping for an immediate extension to their lifespan were disappointed by Dr. Kim Mulvihill, a columnist for CBS, who helpfully pointed out that people who adopt these four behaviours do not “automatically gain 14 years.” “The 14 years is an average across the population of what’s theoretically possible” realized Tim Armstrong for CBC in Canada. Down Under, the paper was covered in the Sydney Morning Herald and the Australian.
One of the key things about the paper as made evident in the methods section – in contrast to the usual confusing barrage of information from medical journals, government reports and the popular media – was the use of simple health indicators to score participants in the questionnaire for the study. The authors state that an analysis of how the combined health behaviours affect quality of life is also needed (although the four factors are not thought to rule out watching the cricket and drinking a beer, which will leave one public health expert interviewed for the Age in Melbourne relieved). Nevertheless, the results of the study do suggest that these four achievable lifestyle changes could have a marked improvement on the health of middle-aged and older people, which is particularly important given the ageing population in the UK and other European countries.
You can respond to the freely available article through our reader response system.
In terms of the public health implications of this study, it’s great to see that people can increase their chances of longevity without losing weight.
That’s not to say that achieving a healthy weight isn’t important, but weight loss is difficult and daunting. For people who already drink moderately and don’t smoke, advice to eat enough produce and not be sedentary seems much more doable. And once they’ve incorporated those behaviors, weight loss should be easier (though not a foregone conclusion, as I can say from experience).